SAMPLE for the demonstration: a fictional certificate, not a real document. In real use this is the scan or PDF the coordinator attaches.

State medical license

Ridgeline Health Partners credential file

Issued toTheo Ramirez, PA-C
CredentialState medical license (TN)
NumberTN-LIC-DEMO-4046
Issued byTennessee medical board (demo record)
Valid fromMay 5, 2025
Valid throughMay 5, 2027

Fictional provider and number. Close this tab to return to the Credential Tracker.